| Doctor Name: | MR. JERRY J HOSTERMAN |
| NPI Number: | 1033226824 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMSW |
| License Number: | 6801083748 |
| Business Practice Address: | 51 Brown St Ste 6 Croswell, MI - 484221159 |
| Business Phone Number: | 8106790200 |
| Business Fax Number: | 8106790202 |
| Mailing Address: | 2649 Hayes Rd, YALE |
| State: | MI |
| Postal Code: | 480974864 |
| Phone Number: | 8103872273 |
| Fax Number: | |
| NPI Enumeration Date: | 08/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6801083748 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |